Before breast cancer, Jean Kees worked out three to four times a week. She practiced yoga, hiked with friends and lifted weights at the gym.

But a mastectomy, six months of chemotherapy and a month of radiation treatments left her tired, weak and unable to move in ways she'd always taken for granted.

Scar tissue around her incision stopped her from lifting her arm above her head or reaching into cupboards.

"There was really no point in me trying to join the club again because I knew I couldn't do it," said Kees. "You get really, really tired. I wanted to find something I could do."

Physical therapy helped, but Kees didn't notice big improvements until she started taking a class at her gym in Bellevue designed specifically for women recovering from breast cancer surgery.

Kees' complaints, including fatigue and range of motion limitations, are common among breast cancer survivors.

"When you have the surgery the inclination is to curl into yourself," Kees said. "You protect the shoulder. You protect the chest. One of the first things you have to learn is to straighten out again."

Davis, a former professional dancer who lives in Lynnwood, first applied dance and music to breast cancer recovery when her mother was diagnosed in 1980.

Physical therapy has long been the standard treatment for recovering from post-surgery stiffness, but Davis believes her dance program also provides emotional healing and support.

Her exercise program, now taught at hospitals and gyms around the country, evolved during one-on-one morning sessions at her Philadelphia dance studio with her mother.

Davis and her two brothers (both surgeons) worked together to modify dance movements for their mom, a vivacious ballroom dancer they couldn't rouse from depression after her mastectomy.

"She loved to dance, she just didn't want to hurt herself," Davis said.

Along with shoulder shrugs and neck circles to loosen up, mother and daughter practiced a favorite move -- a ballet classic in which dancers bring both arms in from their sides, slowly drawing them up and overhead.

"She felt so graceful," Davis said. "She felt beautiful."

Her surgeon noticed progress too. Soon Davis was teaching a class using the same moves that helped her mother to cancer patients at Albert Einstein Medical Center in Philadelphia.

Davis stopped teaching when she moved to Washington, but a few years later she was diagnosed with breast cancer. After her own mastectomy, Davis said she called her brother crying in pain. "He said why aren't you doing your program?"

Since then, Davis has made it her mission to offer The Lebed Method: Focus on Healing Through Movement and Dance wherever women are recovering from breast cancer. She trains instructors, who work in health clubs and hospitals in 30 states, and speaks to breast cancer support groups across the nation.

Her non-profit will pay for anyone who wants to take the class where it's offered for a fee, said Davis, who teaches a free session at Gilda's Club in Seattle on Monday mornings.

At a downtown Seattle class every Thursday evening, participants move slowly and deliberately, reaching their arms to the side, pressing their palms high above their heads. The movements flow gently, slowly coaxing women to trust their bodies again.

The classes start with movements intended to minimize lymphedema, a common complication after cancer treatment that causes swelling in the arms and legs.

While many studies suggest exercise can reduce cancer risk, the link between physical activity and breast cancer recurrence is less clear.

In a recent study, researchers in Connecticut found promising improvements in range of motion and emotional well-being among 35 women who attended Focus on Healing classes.

"We did find some positive results which have implications for future research," said Susan Sandel, who has a doctorate in psychotherapy and dance movement therapy. Sandel, a certified Focus on Healing instructor, teamed up for the study with a physician at the University of Connecticut. (She declined to discuss the details of their findings until the study is published).

Other research suggests even a moderate amount of exercise can relieve fatigue after breast cancer surgery and other treatments, said Tish Knobf, associate professor of nursing at Yale University.

Still, women often must seek their own post-treatment recovery program, Knobf said.

"Doctors and nurses are not good at the end of treatment at developing a plan for people to transition to surviving and becoming healthy," Knobf said. "You're usually focused on managing the disease."